MBBS 2nd PROF

MICRIBIOLOGY
Sample Paper: PAPER-B, BFUHS
TIME:3 Hours Max Marks: 100

Q1. Multiple Choice Questions, Use OMR sheet to answer, 1x20=20, Time for MCQs-30 min
1. A 40-year man came to the emergency with high grade fever, productive cough
and shortness of breath for the last 2 days. X-ray showed consolidation in right
lower lobe of lung. Sputum Gram stain showed scanty pus cells and Gram-
positive lanceolate diplococci with a halo. Which of the following is the most likely
causative agent in this case?
A. Klebsiella pneumoniae
B. Mycoplasma pneumoniae
C. Haemophilus influenza
D. Pneumococcus pneumioniae
2. A 25-year, sexually active male presented with dysuria and urethral discharge.
Microscopic examination of the discharge showed many pus cells and
intracellular gram-negative cocci. Which of the following is the most likely causative
agent in this case?
A. Chlamydia trachomatis
B. Mycoplasma hominis
C. Neisseria gonorrhoeae
D. Gardnarella vaginalis
3. A 26-year pregnant patient developed fever and lymphadenopathy during first
trimester and was found to have a rising titre of Anti-Toxoplasma antibodies. She
delivered a full-term baby with no apparent signs of in-utero infection. Which is
the best parasite-specific antibodies to diagnose acute infection in the neonate?
A. IgM
B. IgA
C. IgG
D. IgE
4. A 40-year farmer presented with mildly itching red pustules on his arm. These
started to blister1-2 days later and then ruptured. He has cows, horses and sheep in
his farm. On examination, black eschar was found with fluid drained from a
vesicle. Gram staining reveals gram positive bacilli in chains with ‘Medusa head’
appearance of colonies. Which of the following is the most likely causative agent in this
case?
A. Clostridium pefringens
B. Mycoplasma hominis
C. Bacillus anthracic
D. Ureaplasma urealyticum

5. A 75 year old male was admitted for fever and an exfoliative skin condition. The
skin of his torso showed erythema, epidermal peeling and pustular lesions. Culture
shows a Gram-positive organism that is highly salt-tolerant. Which of the
following lab test is useful to confirm the pathogenic species of the causative
agent?
A. Bile solubility
B. Esculin hydrolysis
C. Optochin sensitivity
D. Coagulase production
6. A patient was catheterized on day 1 of hospitalization. On day 4, patient
 developed 1010F fever. Urine culture on day 5 grew significant E. coli. Which of
the following urinary tract infection is the most likely diagnosis?
A. Catheter associated symptomatic UTI
B. Non catheter associated symptomatic UTI
C. Asymptomatic bacteremic UTI
D. No UTI
7. A 25 year female with 30 weeks pregnancy presented to obstetrician with
complaints of high grade fever and chills for 2 days. The doctor immediately
ordered routine blood and urine examination along with HRP2 antigen, which
turned out to be positive. Which of the following is the most likely causative agent in
this case?
A. Dengue virus
B. Salmonella typhi
C. Plasmodium falciparum
D. Chikungunya virus
8. An NGO started a vaccination program to prevent the females from cervical
cancer in the age group of 11-12 yrs. Which viral infection is the target for the said
vaccine?
A. Cytomegalovirus
B. Human papilloma virus
C. Human herpes virus 8
D. Epstein barr virus
9. A 59 year male presented to the urologist with the complaints of hematuria for 5
days. The doctor on duty ordered all the routine blood and urine tests. MRI of
abdomen revealed carcinoma of bladder. Which of the following is the most likely
parasitic cause?
A. Helicobacter pylori
B. Schistosoma haematobium
C. Schistosoma japonicum
D. Clonorchis sinesis
10. A 45 yr Male patient presented to the emergency department with the complaints
of severe pain in the right eye accompanied with swelling for 5 days. On
examination resident doctor noted proptosis and necrotic areas with black eschar
formed on the palate and nasal septum.The biopsy tissue of the involved area was
sent for KOH examination which revealed non septate broad branching
hyphae.Which of the following is the most likely diagnosis?
A. Mucormycosis
B. Aspergillosis
C. Presumed ocular histoplasmosis syndrome
D. Fusariosis
11. A 6 year old child presented to the emergency with high grade fever and sore
throat. On examination the child appeared ill. There was presence of greyish
membrane and odema in the tonsillar area and pharyngeal wall. H/o vaccination
was absent. The Gram stain of the membranous material collected with the help of
swab revealed the presence of Gram positive bacilli. Albert stain showed the
presence of green coloured V or L bacilli with bluish black metachromatic
granules. The causative agent is:
A. Bacillus anthracis
B. Clostridium difficile
C. Streptobacillus moniliformis
 D. Corynebacterium diphtheriae
12. A 25 year old man presented to the medicine OPD with complaints of cough with
blood stained sputum since 3 weeks. He also gave H/O of evening rise of
temperature and weight loss over a period of past 6 months. ZN staining of the
sputum revealed the presence of acid fast bacilli with beaded appearance. The
generation time of the causative agent is:
A. 20 minutes
B. 20 hours
C. 20 days
D. 2 minutes
13. A 19-year male presents to STD clinic with a urethral discharge and dysuria. A
swab specimen was collected and examined by Gram stain. Polymorphonuclear
leucocytes were detected in exudate along with intracellular and extracellular
gram-negative diplococci. Which of the following is the best possible treatment?
A. No treatment required
B. With a tetracycline-based antibiotic
C. With 3rd generation cephalosporin
D. Combination of ceftriaxone and doxycycline
14. A man who has a penile hard chancre appears in a hospital’s emergency service.
The Venereal disease research laboratory (VDRL) test is negative. The most
appropriate course of action for the physician in charge would be to:
A. Send the patient home untreated
B. Repeat the VDRL test in 10 days
C. Perform dark-field microscopy for treponemes
D. Swab the chancre and culture on Thayer-Martin agar
15. A known HIV positive patient is admitted following an accident. The resident
doctor who changed his dressing the next day found it to be soaked in blood.
Which of the following would be the right method of discarding the dressing?
A. Pour 1% hypochlorite on the dressing material and put in appropriate bag.
B. Pour 2% hypochlorite on the dressing material and put in appropriate
C. Pour 5% hypochlorite on the dressing material and put in appropriate bag
D. Put the dressing material directly into an appropriate bag.
16. A nursing sister in the COVID Vaccination area, at the end of the day after cutting
the tip of needles in the needle cutter will discard the syringe in which bin?
A. Yellow
B. Red
C. White
D. Blue
17. A seven-year boy hospitalised with high grade fever, headache, vomiting & stiff
neck. He had history of swimming in the ponds frequently. Which of the following
is the most likely causative agent in this case?
A. Entamoeba histolytica
B. Toxoplasma gondii
C. Naegleriafowleri
D. Plasmodium falciparum
18. Four days old child admitted in the ICU was diagnosed to have meningitis with
septicaemia. His mother had peripartum fever & puerperal sepsis. Which of the
following is the most likely causative agent in this case?
A. Escherichia coli
B. Streptococcus agalactiae
C. Neisseria meningitidis
 D. Haemophilus influenzae
19. HIV positive patient reported to the hospital with headache, fever, loss of vision
& neck rigidity. CSF was collected & on negative staining capsulated microbes
were observed. The provisional diagnosis is:
A. Candidiasis
B. Histoplasmosis
C. Coccidiomycosis
D. Cryptococcosis
20. A five-year old girl developed painful vesicular lesions around the mouth. There
was history of similar lesions with two of her siblings. Tzanck smear of the
vesicular fluid was positive for multinucleated giant cells. What is the likely
organism associated?
A. Herpes simplex virus
B. Molluscum contagiosum virus
C. Popova virus
D. Norwalk virus

Q2. A child aged 7 years with high grade fever, toxic, pain in the throat, inability to swallow
was brought to the casualty. On examination a white patch, was found on the fauces, which
started bleeding when touched. No history of immunization is available.
a. What is the differential diagnosis and your probable diagnosis?
b. Describe in detail the pathogenesis.
c. Discuss its laboratory diagnosis and management. 4+4+4=12

Q3. Short answers: 5x4=20

a) Explain the etiology, pathogenesis and lab diagnosis of gas gangrene.
b) Recent advances in laboratory diagnosis of pulmonary tuberculosis.
c) Enumerate the causes of bacterial meningitis and describe its lab diagnosis.
d) Microbiological testing of water and presumptive coliform count

Q4. Explain why 3x 5=15

a) Zoster occurs after varicella infection
b) Treponemal tests are preferred over non treponemal tests
c) Vector-borne diseases are emerging
d) Non-human nematodes causes larva migrans
e) Cryptococcus neoformans is an opportunistic infection

Q5. Short answer (applied aspects) 6 x 3=18

a) Discuss the diagnostic approach for urinary tract infection
b) What are congenital infections? How will you diagnose a case of congenital syphilis.
c) Describe the segregation and disposal of biomedical waste in COVID 19 testing lab
as per the latest guidelines.

Q6. Short answers: 5x3=15

a) Primary amoebic meningoencephalitis
b) Discuss Infection Control - Standard Precautions
c) Discuss non-maleficence as a guiding principle in sample collection for lab
investigation.